When people use cocaine, their brains release lots of dopamine. When people take cocaine, their blood pressure goes up and their heart races. There are treatments for cocaine use disorder (cocaine addiction), but people often relapse and use it again.
To make cocaine, the leaves are chemically processed and treated to form a powder. Programs use a voucher or prize-based system that offers patients who abstain from cocaine and other drugs with rewards. One form of behavioral therapy that shows positive results in people with cocaine use disorders is contingency management (CM), also called motivational incentives. It reduces blood flow in the gastrointestinal tract, which can lead to tears and ulcerations.3 Many people who use cocaine chronically lose their appetite and experience significant weight loss and malnourishment.
Researchers have developed a computerized form of CBT (CBT4CBT) that patients use in a private room of a clinic.43-45 This interactive multimedia program closely follows the key lessons and skill-development activities of in-person CBT in a series of modules. This therapy can also be used in conjunction with other treatments, thereby maximizing the benefits of both.38 But many behavioral treatments have proven to be effective in both residential and outpatient settings. The faster the drug is absorbed, the more intense the resulting high, but also the shorter its duration. Cocaine’s effects appear almost immediately after a single dose and typically disappear within a few minutes to an hour. The stress circuits of the brain are distinct from the reward pathway, but research indicates that there are important ways that they overlap.
Cocaine-exposed babies also tend to have smaller heads, which generally reflect smaller brains. Cocaine base/crack can be smoked because it vaporizes with little or no decomposition at 98 °C (208 °F), which is below the boiling point of water. Some local statutes in the US treat spoons that are too small and thus “unsuited for the typical, lawful uses of a spoon” as drug paraphernalia.
Cocaine
Farmers are able to use unregulated and highly toxic pesticides due to the clandestine nature of drug production. Such areas are chosen for coca cultivation due to their remote locations, minimising chances of detection. The UNODC approximated that 97,622 hectares of primary forest were cleared for coca cultivation during 2001–2004 in the Andean region. Due to the illegal nature of coca production, farmers make little effort in soil conservation and sustainability practices as seen in the high mobility and short life of coca plots in Colombia. Many of these hazardous substances, such as solvents and acids, remain in the paste after processing. Seizures rose by 68% from 2019 to 2023, while the number of users increased from 17 million in 2013 to 25 million in 2023, according to the UNODC World Drug Report 2025.
- While domestic clandestine laboratories could theoretically reduce reliance on offshore production and international smuggling—as seen with illicit methamphetamine—manufacture and synthetic production of cocaine remains rare.
- Before trafficking to the United States, the cocaine is frequently adulterated with levamisole.
- Cocaine abuse can trigger addiction-related structural neuroplasticity in the human brain, although the permanence of such changes remains uncertain.
- These findings mirror human epidemiological data showing a link between nicotine use and increased risk of later cannabis and cocaine use, as well as other substances.
What are treatments for cocaine use disorder?
Normal amounts of dopamine can make us feel happy, alert and focused. This part of our brain controls our ability to feel pleasure. Crack gets its name from the crackling sound it makes as it’s processed or cooked. Cleveland Clinic is a non-profit academic medical center. Cocaine use disorder (addiction) can affect your personal relationships. Cocaine is a very addictive stimulant drug.
Dependence and withdrawal
This substance is favored in these areas primarily because it is inexpensive and more accessible than refined cocaine. In the National Survey on Drug Use and Health, white respondents reported a higher rate of powdered cocaine use, and Black respondents reported a higher rate of crack cocaine use. The Anti-Drug Abuse Act of 1986 mandated the same prison sentences for distributing 500 grams of powdered cocaine and just 5 grams of crack cocaine. In 1914, The New York Times published an article titled “Negro Cocaine ‘Fiends’ Are a New Southern Menace,” portraying Black people who used cocaine as dangerous and able to withstand wounds that would normally be fatal. In Peru, for example, legal coca cultivation is monopolized by the state company National Coca Company (ENACO), yet approximately 90% of coca leaves produced in the country are diverted to illegal actors for cocaine manufacturing.
Cocaine/levamisole-associated syndromes
It comes in powder form as well as solid chunks. Cocaine is a highly addictive drug that ups your levels of alertness, attention, and energy. Aftercare serves to reinforce these traits and address problems that may increase vulnerability to recurrence, including depression and declining self-efficacy.48 TCs can also provide support in other important areas—improving legal, employment, and mental health outcomes.46,47
Cocaine is typically used orally, intranasally, intravenously, or by inhalation. Share sensitive information only on official, secure websites. When the Spanish arrived in South America, they initially banned coca but soon legalized and taxed it after seeing its importance to local labor. Coca leaves have been used by indigenous South Americans for thousands of years, both as a stimulant and for medicinal purposes.
How common is cocaine use?
For decades, federal regulations throughout the U.S. and Europe have been in effect to target the movement and utilization of these and other chemicals commonly used in the mass production of cocaine.7,8 Generally speaking, all cocaine is manufactured similarly. While Colombia is the largest producer of cocaine in the world, they often have to harvest significantly more coca plants to produce similar amounts of cocaine than Bolivia or Peru, as their coca plants tend to grow more cocaine.4,5 In these countries, cocaine is extracted and processed from coca plants, which thrive in the natural environment along the ridges of the Andes mountains in South America and in lowland jungles.1,3,4 Nearly all cocaine that reaches America comes from Colombia and is illegally trafficked across the US-Mexico border and through legal ports of entry.2 Cocaine is also trafficked into the U.S. from Bolivia and Peru, two other countries where cocaine is also mass produced.4,5
How Do People Use Cocaine?
While cocaine and crack cocaine highs are brief, the drug may stay in your system for up to three days. But it carries many risks, including overdose and serious physical and mental side effects as well as addiction. In early tests, a vaccine helped reduce the risk of relapse in people who use Cocaine vs Heroin cocaine. The drug disulfiram, which is used to treat alcoholism, has shown some promise for cocaine addiction.
Your chances of getting HIV, the virus that causes AIDS, are higher if you use cocaine. They can also add other drugs like amphetamine, fentanyl, heroin, or procaine. To make more money, dealers may “cut” the drug with other substances, like flour, baking soda, cornstarch, or talcum powder. A typical dose of snorted cocaine is between 30 and 70 milligrams. These unpleasant effects often make you want to use the drug again.
- It is legal for people to use coca leaves in the Andean Community, such as Peru and Bolivia, and Argentina, where they are chewed, consumed in the form of tea, or are sometimes incorporated into food products.
- The drug disulfiram, which is used to treat alcoholism, has shown some promise for cocaine addiction.
- Monoamine oxidase inhibitors (MAOIs) should not be combined with other psychoactive substances (antidepressants, painkillers, stimulants, including prescribed, OTC and illegally acquired drugs, etc.) except under expert care.citation needed
- This hypothesis suggests that some individuals use cocaine to address underlying neurochemical or psychological issues.
- The manufacturer says the torches only work on much purer forms of cocaine than are found on the street.
Numerous medications have been investigated for use in cocaine dependence, but as of 2015update, none of them were considered to be effective. Depressive symptoms are linked to worse outcomes like longer depression, treatment, and risky behaviors. About 25% of adults with attention deficit hyperactivity disorder (ADHD) use cocaine, and 10% develop a cocaine use disorder during their lifetime. These mice self-administer cocaine at lower doses and display a greater propensity for relapse after withdrawal ΔFosB also enhances sensitivity to reward by upregulating the AMPA receptor subunit GluR2 and downregulating the expression of dynorphin.
Historically, snuff spoons were used for cocaine in the 20th century, hence the names “cocaine spoon” and “coke spoon”. The cocaine typically is poured onto a flat, hard surface and divided into “bumps”, “lines”, or “rails”, and then insufflated. Snuff spoons, hollowed-out pens, cut straws, pointed ends of keys, long fingernails or artificial nails, and tampon applicators are also used to insufflate cocaine. Most banknotes have traces of cocaine on them; this has been confirmed by studies done in several countries.
During its production, various toxic chemicals are used to extract coca alkaloids from the coca leaves. In countries where cocaine is illicitly produced, an intermediate product known as cocaine paste—often referred to as “poor man’s cocaine”—is frequently smoked in impoverished communities. The U.S. is the world’s largest consumer of cocaine, while South America, as a continent, ranks third in terms of consumer market size. Concurrently, record levels of cocaine production have enabled traffickers to enter new markets across Asia and Africa, reflecting the expanding global reach of cocaine trafficking. While this act is often seen as the start of prohibition, the act itself was not actually a prohibition on cocaine, but instead it set up a regulatory and licensing regime. In addition, some parts of Europe, the United States, and Australia allow processed cocaine for medicinal uses only.
Cocaine use can also lead to a higher risk of infections such as HIV and hepatitis C, particularly if you share needles. Your body and mind begin to rely on the drug. Stronger, more frequent doses cause long-term changes in brain chemistry. Your brain may become less responsive to other natural rewards, such as food and relationships. This can lead to a negative mood when you don’t take the drug. This can lead to a dangerous addiction or overdose.